OBJECTIVE: To investigate the effect of workplace neck/shoulder strength training with and without regular supervision on neck/shoulder pain and headache among office workers.
METHOD: A 20-week cluster randomized controlled trial among 351 office workers was randomized into three groups: two training groups with the same total amount of planned exercises three times per week (1) with supervision (3WS) throughout the intervention period, (2) with minimal supervision (3MS) only initially, and (3) a reference group (REF). Main outcome is self-reported pain intensity in neck and shoulder (scale 0-9) and headache (scale 0-10).
RESULTS: Intention-to-treat analyses showed a significant decrease in neck pain intensity the last 7 days in 3MS compared with REF: -0.5 ± 0.2 (P < 0.02) and a tendency for 3WS versus REF: -0.4 ± 0.2 (P < 0.07). Intensity of headache the last month decreased in both training groups: 3WS versus REF: -1.1 ± 0.2 (P < 0.001) and 3MS versus REF: -1.1 ± 0.2 (P < 0.001). Additionally, days of headache decreased 1.0 ± 0.5 in 3WS and 1.3 ± 0.5 in 3MS versus REF. There were no differences between the two training groups for any of the variables.
CONCLUSION: Neck/shoulder training at the workplace reduced neck pain and headache among office workers independently of the extent of supervision. This finding has important practical implications for future workplace interventions.
The impact of migraine headaches on worker productivity and quality of life is significant. A medical center employee health department implemented an evidence-based, multicomponent intervention to manage migraine headaches for a population of more than 3,500 employees. The intervention consisted of education to identify and avoid headache triggers, coaching on dietary and lifestyle changes, and prescriptions for medications to prevent and treat headaches. This article presents preliminary data on the feasibility and effectiveness of the intervention. The frequency and severity of headaches were measured at baseline and 3, 6, 9, and 12 months after baseline using the Migraine Disability Assessment questionnaire. At 12 months, 28 participants who completed testing reported that the frequency of headaches had decreased by 76.1%, severity by 31.3%, and perception of disability by 66.5%. This pilot study used a convenience sample and no control group. However, results are promising and recommendations are made for future studies.
BACKGROUND: Noninvasive physical management is often prescribed for headache and neck pain. Systematic reviews, however, indicate that the evidence of its efficacy is limited. Our aim was to evaluate the effectiveness of a workplace educational and physical program in reducing headache and neck/shoulder pain.
METHODOLOGY/PRINCIPAL FINDINGS: Cluster-randomized controlled trial. All municipal workers of the City of Turin, Italy, were invited to participate. Those who agreed were randomly assigned, according to their departments, to the intervention group (IG) or to the control group and were given diaries for the daily recording of pain episodes for 1 month (baseline). Subsequently, only the IG (119 departments, 923 workers) began the physical and educational program, whereas the control group (117 departments, 990 workers) did not receive any intervention. All participants were again given diaries for the daily recording of pain episodes after 6 months of intervention. The primary outcome was the change in the frequency of headache (expressed as the proportion of subjects with a ≥50% reduction of frequency; responder rate); among the secondary outcomes there were the absolute reduction of the number of days per month with headache and neck/shoulder pain. Differences between the two groups were evaluated using mixed-effect regression models. The IG showed a higher responder rate [risk ratio, 95% confidence interval (CI)] for headache (1.58; 1.28 to 1.92) and for neck/shoulder pain (1.53; 1.27 to 1.82), and a larger reduction of the days per month (95% CI) with headache (-1.72; -2.40 to -1.04) and with neck/shoulder pain (-2.51; -3.56 to -1.47).
CONCLUSIONS: The program effectively reduced headache and neck/shoulder pain in a large working community and appears to be easily transferable to primary-care settings. Further trials are needed to investigate the program effectiveness in a clinical setting, for highly selected patients suffering from specific headache types.
TRIAL REGISTRATION: ClinicalTrials.gov NCT00551980.
The objective of this study is to evaluate the effectiveness of an educational and physical program in reducing behavioral or somatic symptoms along with headache, neck and shoulder pain in a working community. A controlled, non-randomized trial was carried out in a working community and 384 employees were enrolled and divided into a study group (Group 1) and a control group (Group 2). The Group 1 received a physical and educational intervention, consisting of relaxation and posture exercises and the use of visual feedback. After 6 months, the intervention was administered to the Group 2. Both groups were then followed for an additional 6 months until the end of the trial. The presence of accompanying symptoms was investigated with a semi-structured interview using a checklist of 20 items, along with headache, neck, and shoulder pain parameters and the prevalence of generalized anxiety disorder and depression, in three clinical examinations at baseline, after 6 months and after 12 months. For each symptom, as well as the presence of any type of symptom, the differences between groups in the prevalence at the clinical examinations following the baseline were evaluated by applying logistic models. After 6 months, the probability of the presence of any type of symptom was significantly lower in the Group 1 (OR 0.69, 95% CI 0.56-0.85) with respect to the Group 2. After 12 months, the pooled estimation did not show any significant difference of symptom prevalence between groups (OR 0.80, 95% CI 0.64-1.00). In conclusion, this is the first longitudinal study relative to accompanying symptoms. Its results suggest the effectiveness of this cognitive program in reducing the burden of physical and psychiatric complaints in a large, working population.
OBJECTIVE: This paper investigates secondary outcomes (headache) in a randomized controlled trial with physical exercise among office workers with neck/shoulder pain.
METHODS: A total of 198 office workers with frequent neck/shoulder pain were randomly allocated to either one of two intervention groups (10 weeks of resistance training with elastic tubing for 2 or 12 minutes per day, 5 times a week) or the control group, which received weekly health information. Secondary outcomes included changes in frequency, intensity, and duration of headache after ten weeks.
RESULTS: Compared with the control group, headache frequency decreased in the 2- and 12-minute intervention groups [0.64 days/week (95% confidence interval [95% CI]) 0.23-1.0) and 0.79 days/week (95% CI 0.37-1.2), corresponding to a 43% and 56% decrease from baseline, respectively]. Intensity and duration of the remaining headaches were unaffected.
CONCLUSIONS: Two minutes of daily resistance training for ten weeks reduces headache frequency among office workers with neck/shoulder pain. The vast number of adult workers suffering from one or two days of weekly headaches and who could potentially comply with and benefit from brief exercise programs stresses the applicability of our findings.
OBJECTIVES: Study objectives were to determine the impact of migraine and severe headache on employer burden, resource utilization, and workplace productivity before and after a migraine education program; estimate the associated costs in an employed sample; and evaluate whether a migraine management program can help manage costs.
METHODS: Employees of three US companies were informed of a company-specific web site with information regarding the study as well as a validated migraine screening questionnaire. Employees who screened positive for migraine completed a baseline survey examining migraine frequency and severity, Migraine Disability Assessment (MIDAS) grade, medical resource utilization, and impact on workplace productivity. After the baseline survey, employees received three print packets and six e-mailed newsletters of migraine management educational materials. Six months after the last mailing, participants completed a follow-up survey. Participants were stratified by MIDAS grade and prevention needs status. Direct and indirect migraine-related costs were estimated and differences between baseline and follow-up survey results were analyzed.
RESULTS: Indirect costs and measures of migraine impact improved after the educational program. Three-month indirect costs of migraine decreased 34.5% and total costs decreased 14.7% after the educational program.
CONCLUSION: Migraine management programs, including screening questionnaires and educational initiatives, may potentially help reduce the employer cost burden due to improvements in their employees' disability associated with migraine headache.
This study was an 8-month controlled trial to evaluate the effectiveness of a workplace educational and physical programme in reducing headache and neck and shoulder pain. Central registry office employees (n = 192; study group) and 192 peripheral registry office and central tax office employees (controls) in the city of Turin, Italy were given diaries for the daily recording of pain episodes. After 2 months, the study group only began the educational and physical programme. The primary end-point was the change in frequency of headache and neck and shoulder pain expressed as the number of days per month with pain, and as the proportion of subjects with a >or= 50% reduction of frequency (responder rate). The number of days of analgesic drug consumption was also recorded. Diaries completed for the whole 8 months were available for 169 subjects in the study group and 175 controls. The baseline frequency of headache (days per month) was 5.87 and 6.30 in the study group and in controls; frequency of neck and shoulder pain was 7.12 and 7.79, respectively. Mean treatment effects [days per month, 95% confidence interval (CI)] on comparing the last 2 months vs. baseline were: headache frequency -2.45 (-3.48, -1.43); frequency of neck pain -2.62 (-4.09, -1.16); responder rates (odds ratio, 95% CI) 5.51 (2.75, 11) for headache, 3.10 (1.65, 5.81) for neck and shoulder pain, and 3.08 (1.06, 8.90) for days with analgesic drug consumption. The study suggests that an educational and physical programme reduces headache and neck and shoulder pain in a working community.
To investigate the effect of workplace neck/shoulder strength training with and without regular supervision on neck/shoulder pain and headache among office workers.
METHOD:
A 20-week cluster randomized controlled trial among 351 office workers was randomized into three groups: two training groups with the same total amount of planned exercises three times per week (1) with supervision (3WS) throughout the intervention period, (2) with minimal supervision (3MS) only initially, and (3) a reference group (REF). Main outcome is self-reported pain intensity in neck and shoulder (scale 0-9) and headache (scale 0-10).
RESULTS:
Intention-to-treat analyses showed a significant decrease in neck pain intensity the last 7 days in 3MS compared with
REF:
-0.5 ± 0.2 (P < 0.02) and a tendency for 3WS versus
REF:
-0.4 ± 0.2 (P < 0.07). Intensity of headache the last month decreased in both training groups: 3WS versus
REF:
-1.1 ± 0.2 (P < 0.001) and 3MS versus
REF:
-1.1 ± 0.2 (P < 0.001). Additionally, days of headache decreased 1.0 ± 0.5 in 3WS and 1.3 ± 0.5 in 3MS versus REF. There were no differences between the two training groups for any of the variables.
CONCLUSION:
Neck/shoulder training at the workplace reduced neck pain and headache among office workers independently of the extent of supervision. This finding has important practical implications for future workplace interventions.
